To implement the strategy of healthy China and promote the construction of "new medicine science", it is urgent to focus on new needs and challenges to advance the reform of medical education curricula in China. Using literature research methods, we summarize the process of modern medical education curriculum reforms in the United States, and discuss the main features of the third-round reforms—introducing the concept of value-based medicine, offering health systems science courses, and promoting the curriculum system reform from the perspectives of learning time, curriculum integration, and learning methods. Based on these features, we put forward the enlightenment for the reform of medical education curricula in China.

Objective:To construct a core competency indicator system for prehospital emergency nursing staff in stroke.Methods:A preliminary draft of the core competency indicator system for prehospital emergency nursing staff in stroke was formulated through literature research and group discussions. From January to March 2023, 15 experts were selected, and after two rounds of Delphi expert consultations, the indicators at all levels were modified and improved to form the final version of the indicator system. The degree of expert enthusiasm was expressed as the effective response rate of the questionnaire, the degree of expert authority was expressed as the expert authority coefficient ( Cr), and the degree of expert opinion coordination was expressed as the Kendall harmony coefficient and coefficient of variation. Results:In two rounds of Delphi expert consultation, the effective response rates of the questionnaire were 100.00% and 93.33%, respectively, and the expert authority coefficients were 0.853 and 0.861. After the second round of expert consultation, the coefficient of variation for each item was from 0 to 0.23, and the Kendall's harmony coefficient was 0.185 ( P<0.01). The final constructed indicator system included four primary indicators, 14 secondary items, and 31 tertiary items. Conclusions:The constructed core competency indicator system for prehospital emergency nursing staff in stroke is scientific and reliable, and can provide reference for the training and assessment of prehospital emergency nursing staff.

To summarize the nursing experience of a patient with schizophrenia complicated by severe neurodeptic malignant syndrome.Nursing points include:to emphasize monitoring of antipsychotic medications to detect the onset of neurodeptic malignant syndrome as early as possible;to leverage the multidisciplinary team for rapid initiation of acute phase management interventions;to combine multimodal cooling to help rewarm the patient;to implement the stepwise intervention program to promote recovery of bowel function;to emphasize family supportive therapy to restore social functioning;to continue case management by developing a multidisciplinary follow-up plan.After careful management and care by the multidisciplinary team,the patient was successfully discharged from the hospital after a total stay of 47 days.After 3 months of follow-up,the patient's daily life was basically back to normal.

Objective:To analyze and summarize the clinical manifestations, pathological characteristics, treatment, and outcomes of primary malignant melanoma of the esophagus(PMME)in elderly Chinese patients.Methods:A case study of an elderly patient with PMME was conducted at the Department of Gastroenterology in the China-Japan Friendship Hospital.Additionally, literature and case data on elderly PMME cases reported in China up to July 2023 were gathered and analyzed to summarize the epidemiological characteristics, endoscopic manifestations, clinical presentations, diagnosis, treatment, and prognosis of the disease.Results:A comprehensive review of the literature up to July 2023 documented a total of 114 cases of elderly patients with PMME in China, which also included cases from our hospital.Among these cases, there were 68 male patients(59.6%)and 46 female patients(40.4%), ranging in age from 60 to 81 years, with a median age of 65 years.The predominant clinical manifestations observed were dysphagia and choking while eating, followed by chest pain and retrosternal burning sensation.The majority of the lesions were found in the middle and lower segments of the esophagus, predominantly protruding into the lumen, with only 2 cases(1.8%)displaying esophageal mucosal pigmentation.Immunohistochemical analysis revealed that HMB45 was positive in 74 cases(64.9%)and negative in 3 cases(2.6%), while S-100 was positive in 66 cases(57.9%)and negative in 2 cases(1.8%), although data for some patients were not available.Lymph node or distant metastases were present in 45 cases(39.5%), while 38 patients(33.3%)had tumors confined to the esophagus without metastases.Of the 114 patients, 61(53.5%)had a follow-up period ranging from 0.3 to 39 months, with a median follow-up time of 6.75 months.Among the patients who survived during the follow-up period, there were 30 cases(26.3%), with a follow-up time of 1 to 39 months and a median follow-up time of 7.5 months.For the deceased patients, the time from consultation to death ranged from 0.3 to 31 months.Conclusions:Elderly individuals with PMME in China typically present with a gradual onset, nonspecific symptoms, frequent metastasis upon diagnosis, aggressive behavior, and unfavorable outcomes.

Drugs under special management include narcotic drugs,psychotropic drugs,toxic drugs for medical use,radiopharmaceuticals,and pharmaceutical precursor chemicals.Supervising and guiding the clinical use of drugs under special management is one of the important responsibilities of the Pharmaceutical Management and Drug Therapy Committee(Group)of medical institutions.The standard for drugs under special management is led by the Pharmaceutical Professional Committee of the China Hospital Association,which standardizes 16 key elements of organizational management,process management,and quality control management drugs under special management in medical institutions.It can guide the standardized implementation of Pharmaceuticals under special control work in various levels and types of medical institutions.This article elaborates on the methods and contents of formulating standards for Pharmaceuticals under special management,to provide reference and inspiration for medical institutions to carry out special drug drug management and daily related work.

Objective To summarize the experience of integrative palliative care at Peking Union Medi-cal College Hospital and provide a reference for promoting the integrative palliative care model.Methods Twenty cases receiving integrative palliative care at Peking Union Medical College Hospital were collected.The clinical characteristics,reasons for initiating integrative palliative care,the process of integrative palliative care,and feedback from these cases were summarized.Results Insomnia(11 cases,55％)and pain(9 cases,45％)were the most common symptoms requiring control in the 20 cases.The integrative palliative care team assisted in medical decision-making for 17 cases(85％),prepared end-of-life for 9 cases(45％),assisted in the transfer for 3 cases(15％),and provided comfort care for all the 20 cases(100％).Conclusions The integrative palliative care model can help alleviate suffering in end-of-life patients and provide support to patients'families and the original medical teams.This model is worth further promotion within class A tertiary hospitals.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Aim To predict the mechanism of Fufang Congrong Yizhi Capsules (FCYC) in the treatment of mild cognitive impairment (MCI) by network pharmacology method, and further validate it in combination with cellular experiments. Methods TCMSP, Gene-Cards, OMIM and TTD databases, Chinese Pharmacopoeia and related literature were used to screen the active ingredients of FCYC and the targets of MCI treatment. The TCM-compound-target-disease network and PPI of intersection targets were constructed, and the GO and KEGG analysis were performed by the Ehamb bioinformation platform. GO and KEGG analysis were performed through Yihanbo biological information platform. Cell model of MCI was established by PC-12 injury induced by Aβ

Objective To evaluate the application efficacy of low-dose test method combined with variable helical pitch(VHP)technology in computed tomography angiography(CTA)of lower extremity arteries.Methods Eighty patients with CTA imaging of bilateral lower extremity arteries were selected and divided into group A and group B on average.VHP technology was used in group A,and conventional fixed pitch scanning was used in group B.The objective and subjective image quality of the two groups were compared,and the radiation dose and contrast agent dosage of the two groups were recorded and compared.Results The subjective image quality evaluation of group A was significantly better than that of group B,and the difference was statistically significant(Kappa test,P<0.05).In the objective image quality evaluation,the CT value and signal-to-noise ratio(SNR)value of the common iliac artery,popliteal artery and anterior tibial artery in group A were higher than those in group B at the same level,and the differences were statistically significant(P<0.05);The effective dose(ED)value in group A was(6.74±1.20)mSv,and that in group B was(7.93±1.78)mSv(P<0.05).The dosage of contrast agent in group A was significantly lower than that in group B[(73.97±12.15)mL in group A,(82.50±2.61)mL in group B](P<0.05).Conclusion Low-dose test method combined with VHP technology not only can reduce the radiation dose and contrast agent dosage,but also can effectively improve the success rate and image quality of lower extremity arteries examination,which is worthy of clinical application.

Objective:The sensory processing measure-preschool scale(SPM-P)was transformed into Chinese,and its re-liability and validity were tested in preschool children. Method:According to Brislin's translation model,the SPM-P source scale was translated into Chinese and the Chinese version of SPM-P scale was formed.From September 2021 to December 2021,395 preschool children were investigated by cluster stratified random sampling method to test the reliability and validity of the scale. Result:The Chinese version of the SPM-P scale includes 8 dimensions of social participation,vision,hear-ing,touch,body awareness,balance and movement,planning and conception,and overall sensory system,with a total of 75 items.Cronbach alpha coefficient for the overall scale was 0.899,the split half reliability coefficient was 0.700;the test-retest reliability coefficient was 0.899.The item content validity(I-CVI)value was 0.920,the average content validity(S-CVI/Ave)value was 0.984,and the content validity was good;the results of confirmatory factor analysis showed that the construct validity was good;The results of confirma-tory factor analysis showed that the construct validity was good(x2/df=2.41,CFI=0.992,TLI=0.960,RMSEA=0.060,SRMR=0.046);The Chinese version of SPM-P scale was negatively correlated with the corresponding evaluation dimensions of the screening questionnaire for children's sensory integration disorder,and the correla-tion coefficient was between-0.585 and-0.399,with good criterion validity. Conclusion:The Chinese version of SPM-P scale has good reliability and validity and can be used for stan-dardized evaluation of sensory integration ability of preschool children in China.